title: Concern about falling in older women with a history of falls: associations with health, functional ability, physical activity and quality of life.
abstract: BACKGROUND
  Fear of falling has been linked to activity restriction, functional decline, decreased quality of life and increased risk of falling. Factors that distinguish persons with a high concern about falling from those with low concern have not been systematically studied.
  
  
  OBJECTIVE
  This study aimed to expose potential health-related, functional and psychosocial factors that correlate with fear of falling among independently living older women who had fallen in the past year.
  
  
  METHODS
  Baseline data of 409 women aged 70-80 years recruited to a randomised falls prevention trial (DEX) (NCT00986466) were used. Participants were classified according to their level of concern about falling using the Falls Efficacy Scale International (FES-I). Multinomial logistic regression analyses were performed to explore associations between health-related variables, functional performance tests, amount of physical activity, quality of life and FES-I scores.
  
  
  RESULTS
  68% of the participants reported a moderate to high concern (FES-I ≥ 20) about falls. Multinomial logistic regression showed that highly concerned women were significantly more likely to have poorer health and quality of life and lower functional ability. Reported difficulties in instrumental activities of daily living, balance, outdoor mobility and poorer quality of life contributed independently to a greater concern about falling.
  
  
  CONCLUSIONS
  Concern about falling was highly prevalent in our sample of community-living older women. In particular, poor perceived general health and mobility constraints contributed independently to the difference between high and low concern of falling. Knowledge of these associations may help in developing interventions to reduce fear of falling and activity avoidance in old age.
authors.affiliation: The UKK Institute for Health Promotion Research, Tampere University Hospital, Tampere, Finland.
authors.forename: Radhika
authors.initials: R
authors.lastname: Patil
authors.forename: Kirsti
authors.initials: K
authors.lastname: Uusi-Rasi
authors.forename: Pekka
authors.initials: P
authors.lastname: Kannus
authors.forename: Saija
authors.initials: S
authors.lastname: Karinkanta
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D005387:Finland; D006304:Health Status; D006801:Humans; D057187:Independent Living / Q000523:psychology; D016015:Logistic Models; D009043:Motor Activity; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires